Administration of Medications by Direct Support Staff in Day Training Programs

Purpose:

The Division of Developmental Disabilities is providing guidance on how service providers will implement the revisions to Rule 116 related to unlicensed direct support staff administering medications in day service programs.

Background:

As of January 1, 2018, the Mental Health and Developmental Disabilities Administrative Act was amended by changing Section 15.4 allowing authorization by nursing delegation to permit direct care staff to administer medications in day service programs certified to serve persons with developmental disabilities by the Illinois Department of Human Services (IDHS).

Process and Procedures:

Although the Division is providing guidance, it is necessary to emphasize that the use of direct support staff to administer medications in day service programs is NOT required. The final decision is with the RN-Trainer as to whether or not a direct support staff person will be authorized to administer medications. Any day service program that decides to have direct support staff administering medications will need to have a RN-Trainer. Only a RN-Trainer may delegate, authorize and supervise the task of medication administration to direct care staff. A RN who will be training direct support staff at day service programs (and who is not already an IDHS-approved RN-Trainer) can participate in the "IDHS RN-Trainer Medication Administration in the Community" webinars. A RN can register for these webinars on the IDHS Division of Developmental Disabilities Provider Training website.

The training program for the direct support staff shall include educational and oversight components that are similar to those who work in residential programs. The training programs must be conducted by a RN-Trainer. The assessment of the direct care staff skills and competency to administer medications and authorization which is documented on Competency Based Training Assessment (CBTA) form must be completed by the RN Trainer who is delegating this task to the direct care staff.

Non-licensed direct care staff who are to be authorized to administer medications in day training programs under the delegation of the RN- Trainer must meet the following criteria:

• Be age 18 years or older
• Complete high school or its equivalency (GED)
• Demonstrate functional literacy (8th grade reading level)
• Satisfactorily complete the Health and Safety component of the Direct Support Persons Core Training Program or an IDHS approved equivalent Developmental Disabilities Aide Training Program prior to beginning of medication administration training
• Be initially trained and evaluated by a RN-Trainer in a competency-based, standardized medication curriculum specified by IDHS - the classroom portion of this training should be at least 8 hours in length. (If a DSP has already completed the classroom portion of this training, they would not need to repeat it. The day service program would need to have documentation of dates and times this training was completed).
• Score 80% or above on a written exam furnished by IDHS (If a DSP has already completed this exam, it would not need to be repeated. The day service program would need to have documentation of date the exam completed with score obtained on exam).
• Score 100% on an individual-specific, competency-based evaluation performed by a RN- Trainer for each person at the program for whom the direct care staff person is responsible for medication administration. The RN-Trainer must document this evaluation on the Competency Based Training Assessment (CBTA) form for Medication Administration. A list of the medications the direct care staff is authorized to administer to each individual must be attached to the CBTA form. The date completed and the signature of the RN-Trainer must be included on this CBTA form.

If a day service program is utilizing direct support staff to administer medications - the program must follow all Administration Rule 116 Requirements. A RN-Trainer must be available (either on-site or on-call) at all times individuals are present at the day program site to provide direction regarding medication issues.

Effective Date:

Comments, suggestions and/or recommendations send to: DHS.DDDComments@illinois.gov